Progresses of MRI in evaluation of female pelvic organ prolapse / 中国医学影像技术

MRI has the advantages of high soft tissue contrast and resolution,which can provide noninvasive and objective evaluation for the motion of pelvic organs.The commonly used assessment systems include two dimensional systems (pubococcygeal line,sacrococcygeal inferior pubic point line,pelvic inclination correction system,midpubic line,perineal line and HMO system) and three-dimensional systems (three-dimensional pelvic inclination correction system).However,how to choose referent lines and evaluation standards based on MRI is a controversial question.The research progresses of MRI evaluation system for female pelvic organ prolapse were reviewed in the article.

The relationship of the posterior interosseous nerve to the supinator muscle in the dorsal approach to the proximal radius: A descriptive and quantitative anatomic study of Filipino cadavers

BACKGROUND AND OBJECTIVE:The posterior interosseous nerve (PIN) is vulnerable to injury in the dorsal approach to the proximal radius. The goal of this study is to describe the quantitative relationship of the PIN to the supinator muscle in the context of anatomic landmarks. Knowledge of superficial landmarks related to the PIN would hopefully minimize iatrogenic injury to the posterior interosseous nerve.METHODS: 12 cadavers (22 forearms) were dissected and analyzed. The length of the supinator muscle was determined. The oblique distances of the PIN entry and exit points to the proximal and distal borders of the supinator muscle as well as their perpendicular distances to the lateral epicondyle-Lister's tubercle (LE-LT) reference line were measured and recorded. The number of PIN branches inside the supinator substance was recorded. Mean and median values were determined and subjected to statistical analysis.RESULTS: Mean supinator length was 5 centimeters. Ninety-one percent of the cadaveric forearms had PIN branches inside the supinator muscle substance. Twelve of the 22 forearms (55%) had 2 branches. The mean oblique distances of the PIN from the lateral epicondyle to the entry and exit points in the proximal and distal borders of the supinator muscle was 3.52 and 7.31 centimeters, respectively. The mean perpendicular distances of the PIN from LE-LT reference line to the entry and exit points in the proximal and distal borders of the supinator muscle was 1.13 and 1.26 centimeters, respectively. An imaginary danger-zone 4 centimeters wide overlying the LE-LT reference line depicts the possible area where the PIN and its branches may most likely be located.CONCLUSION: The dorsal approach to the proximal radius may allow a safe exposure without causing iatrogenic injury to the posterior interosseous nerve through the use of superficial anatomic landmarks and reference lines in combination with mean measurements from our study.

A Practical Method for Acetabulum Component Assembling in Total Hip Arthroplasty with Lateral Position / 中国运动医学杂志

Objective To get a controllable acetabulum component inclination angle during the total hip arthroplasty(THA) with the lateral position,a new method using a self-made instrument was introduced.Methods Totally 80 consecutive patients undergoing THA at the lateral position were enrolled.Forty acetabular components were assembled using a new method with a self-made instrument referring to the 42 degrees' angle drawn on the wall(group A),while another 40 acetabular cups were implanted free-handedly(group B).The postoperative inclination angle was evaluated on the anterior-posterior pelvic radiographs.Results The average inclination angle was 43.3° ± 3.7°(34.7°～49.1°) in group A and 40.3 ± 4.5o(32.8°～50.7°) in group B.Moreover,40/40 of group A and 38/40 of group B were in the Lewinnek's inclination safe zone(P＞0.05),without significant differences between the two groups.Conclusion It is practical and reliable to decide the acetabular component orientation using the lateral position instrument and reference angle on the wall.

Feasibility of presupposed reference line based on MRI as ultrasound reference line in pelvic organ prolapsed / 中国医学影像技术

Objective To provide valuable references for ultrasonic diagnosis of pelvic organ prolapsed (POP) by finding an eas ily detecting referential line based on MRI.Methods Data of 107 patients who underwent pelvic MRI were retrospectively analyzed.All the patients were divided into 6 groups according to age:Group 1 (20 29 years old),group 2 (30-39 years old),group 3 (40-49 years old),group 4 (50-59 years old),group 5 (60-69 years old) and group 6 (≥70 years old group).Four reference lines were set basing on the median sagittal view of T2WI:PS-PS line (the line connecting the two endpoint of the pubic symphysis),PIAS line (the line connecting the inferior margin of pubic symphysis and the bottom of sphincter internal anal sphincter),PPC line (the line connecting of the inferior margin of pubic symphysis and the point of the pubococcygeous attached on the rectum) and PM line (the line connecting of the inferior margin of pubic symphysis and the M point [the midpoint of the line from the crosspoint of PPC line and the front wall of the rectum mucosa to the bottom of sphincter internal anal sphincter]).The angles between the horizontal line and PS-PS line,PIAS line,PM line,PPC line (angle 1,angle 2,angle 3,angle 4) were measured,respectively.The differences of the angle among various age-groups were compared.The consistency between the two observes were evaluated.Results PM line was the closest line to the horizontal line.There was no statistical differences of angle 1,angle 2 and angle 3 among the 6 groups (all P＞0.05).The difference of angle 4 among the 6 groups were significant (F=3.42,P=0.01).Intergroup pairwise comparisons showed that significant differences were found between group 1 and group 4,group 5,group 6,between group 2 and group 4,group 5,group 6,between group 3 and group 4,group 5,group 6,respectively (all P＜0.05).And no significant difference was found in the other comparisons.The consistency of the two observers in meaning angle 1,angle 3 and angle 4 were good,but the consistency of angle 2 was poor.Conclusion Of all the referential lines,PM is the closest to the horizontal line and is less influenced by the patient's age.However,the feasibility of using PM lines as the ultrasound referential line is still unclear.

A study on usefulness of the reference line in diagnosis of the facial asymmetry

PURPOSE: To assess the relationship between soft tissue reference line and hard tissue reference line using the standardized photographs and the posteroanterior cephalometric radiographs(P-A)in facial asymmetric patients and to compare the differences of angular measurement between normal group and asymmetry group. METHODS: Normal group consisted of 44 persons with normal occlusion and normal facial morphology. Asymmetry group consisted of 90 patients with facial asymmetry. Standardized facial photographs and P-A were taken in all subjects. The horizontal reference lines were bipupillary line in photographs and latero-orbitale line in P-A respectively. The vertical reference line were the line from the midpoint of horizontal reference line perpendicularly. Angular measurement of otobasion canting, lip canting, nose deviation, chin deviation, and maxillary deviation were compared and analyzed in photographs. And angular measurement of mastoid canting, mandibular canting, nose deviation, chin deviation, and maxillary deviation were compared and analyzed in P-A. RESULTS: 1. The variables of photographs and P-A were significantly related in the asymmetry group. 2. Significant differences between all variables except for PT2 and PA2 were shown in the asymmetry group and between PT1 and PA1, PT3 and PA3 in the normal group respectively. 3. Comparison measurement scores of angular difference between control group and experimental group concerning each variable showed significant difference except for PA1. CONCLUSIONS: Soft tissue components may not compensate for underlying skeletal imbalance in nose deviation and chin deviation. The horizontal reference lines in photographs were significant related with the P-A, but angular variables between the two studies show significant differences. Therefore, we do not recommend use photography in the assessment the facial asymmetry as complemented in the P-A.

Analysis of skeletal facial asymmetry with submentovertex cephalometric radiograph / 대한치과교정학회지

This study was performed to investigate the midline having the least difference between the right and left structure among the lines that had been used in the submentovertex analysis and secondarily to know the distribution of asymmetry and it's degree existed normal persons and asymmetric patients. The subjects consisted of 40 normal adult patients and 40 asymmetric adult patients. The computerized anaylses from submentovertex cepholometric radiograph were carried out. The results were as follows; 1. The right and left difference of the perpendicular bisecting line between right and left foramen spinosum was larger than the other midlines in the anterior area and it was decreased gradually as it progressed posteriorly. Specially the difference of this line was the smallest in the area where there was foramen spinosum. 2. The right and left difference of the perpendicular line through crista gali to the line between right and left foramen spinosum was smaller than the other midlines in the anterior area and it was increased gradually as it progressed posteriorly. 3. The right and left difference of the line between crista gali and anterior process of atlas was constant and smaller than the other midlines. 4. Asymmetry was a common finding in both normal and asymmetry group and left or right dominance of asymmetry was not statistically significant. 5. When the analyses were undertaken after submentovertex radiogram was divided into cranial base, upper face and lower face, the more inferior part showed relative asymmetry than the more superior part.

A posteroanterior roentgenocephalometric study of skeletal craniofacial asymmetric patients / 대한치과교정학회지

This study was undertaken to investigate the degree of asymmetry in each part of the head in skeletal craniofacial asymmetric patients, and secondarily to determine the nature of difference existed between asymmetric patients and normal persons. The subjects consisted of 49 asymmetric adult patients and 52 normal adults, and the average ages were 21 years 5 months and 23 years 5 months, respectively. The computerized analyses of 33 linear measurements, 12 angular. measurements, and 8 surface areas from posteroanterior cephalometric radiograph were carried out. The conclusions were as follows; 1. Asymmetry was a common finding in both normal and asymmetric group. 2. When the analyses were undertaken after the head was divided into 3 parts anteroposteriorly and superoinferiorly in the asymmetric patients, there were significant asymmetries in all parts excepts in the cranial base region. 3. When the analyses were undertaken after the head was divided into respective 3 parts anteroposteriorly in the asymmetric patients, the more posterior part showed relative stability than the more anterior part. 4. When the analyses were undertaken after the head was divided into 3 parts superoinferiorly in the asymmetric patients, the more superior part showed relative stability than the more inferior part. 5. Twelve variables indicating asymmetry were selected and the highest ranked variable was Me-Mid-sagittal reference line.